Healthcare Provider Details

I. General information

NPI: 1679012421
Provider Name (Legal Business Name): VERONIKA Y. SMIRNOVA D.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. VERONICA SMIRNOVA

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 9TH AVE
SEATTLE WA
98101-2756
US

IV. Provider business mailing address

9082 162ND PL NE
REDMOND WA
98052-7572
US

V. Phone/Fax

Practice location:
  • Phone: 206-223-6826
  • Fax:
Mailing address:
  • Phone: 425-553-9161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAP60728018
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: